Rising Health Care Costs in California: A Worker Issue

UC Berkeley Labor Center

Blog Series:

1. New blog post series on the problem of rising health care costs for California families with job-based coverage
2. More than half of California adults have job-based coverage
3. Job-based coverage is less common among workers who are black or Latino, low-wage, immigrants, and young adults
4. Health care costs under job-based plans have grown rapidly, while wages remained flat
5. Low-income workers and families struggle with premium contributions
6. High out-of-pocket costs contribute to poor access to care and financial hardships for California workers
7. Increases in health care costs are coming out of workers’ pockets one way or another: The tradeoff between employer premium contributions and wages
8. High Health Care Prices are the Primary Driver of California Workers’ Health Care Cost Problems
9. Proposed Office of Health Care Affordability: An important step towards addressing the health care cost problem for California workers

The Labor Center is publishing a series of blog posts detailing current problems and concerns of Californians with job-based coverage, including the inequities faced by low-income workers, immigrant workers, and workers of color. We will also highlight that much of the burden of health care costs falls on the shoulders of working families, making health care cost growth a workers’ issue.

Key points we will make in this blog post series include:

  • Most mid- and high-wage California workers have job-based coverage;
  • Rates of job-based coverage are significantly lower for low-income, black and Latino, immigrant, and young adult workers than they are for Californians overall;
  • Premiums in California have grown much faster than wages, with family coverage costing more than $20,000 per year, the equivalent of $10 per hour for a full-time worker;
  • Workers bear much of the burden of rising health care costs, not only through higher premiums and out-of-pocket costs but also through foregone wages;
  • Many Californians are paying a high share of income on premium contributions, particularly low-income workers and many workers with family coverage;
  • Some Californians who are offered job-based coverage are nonetheless uninsured due to their inability to afford it;
  • Approximately half of Californians with job-based coverage have no deductible, but for the other half deductible amounts have grown rapidly over the last decade;
  • High out-of-pocket costs cause some to delay or avoid using needed care, a problem that is more common for low-income individuals and those with chronic health conditions;
  • High and often unexpected health care expenses cause financial precarity, with some Californians struggling to afford medical bills and other basic necessities; and
  • The primary driver of rising health care costs is price, not utilization.

We will also discuss actions that employers and government purchasers of health care have taken to attempt to rein in health care costs, exploring solutions that have proven to be effective as well as those that have not. Finally, we will discuss the policy implications of these health care trends to help inform policy discussions underway at the state and federal levels—discussions that are increasingly acknowledging the extent of the affordability concerns for workers with job-based coverage.